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HURT FEELINGS REPORT

To use this form, it must be physically placed in the hands of any Law Enforcement Officer

DATA REQUIRED BY THE PRIVACY ACT OF 1974

AUTHORITY: PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:

S USC 301, Departmental Regulation, 10 USC 3013 and a log of other regulations too To assist whiners in documenting hurt feelings

Whiners should use this form to seek sympathy from someone who cares

Disclosure is voluntary, however, repeated whining may lead to your file being stamped "candy ass" or some other appropriate term

PART I - ADMINISTRATIVE DATA

A. WHINER'S NAME (Last, First, MI)

B. WHINER'S AGE

C. WHINER'S SEX

D. DATE OF REPORT

E. TYPE OF WHINE USED

F. NAME OF THE PERSON FILLING OUT THIS FORM

PART II - INCIDENT REPORT

A. DATE FEELINGS WERE HURT

B. TIME OF HURTFULNESS

C. LOCATION OF HURTFUL COMMENTS

D. WAS ANYONE SYMPATHETIC TO WHINER (Please include paid witnesses)

E. NAME OF PERSON WHO HURT YOUR PANSY ASS FEELINGS

F. HOW LONG DID YOU WHINE

G. WHICH FEELINGS WERE HURT

PART III - INJURY

(Circle all that apply)

1. WHICH EAR WERE THE HURTFULL WORDS SPOKEN INTO?

2. IS THERE PERMANENT FEELING DAMAGE?

 

LEFT

RIGHT

 

BOTH

 

YES

NO

MAYBE

3. DID YOU REQUIRE A "TISSUE" FOR TEARS?

 

4. HAS THIS RESULTED IN A TRAUMATIC BRAIN INJURY?

YES

NO

MULTIPLE

 

YES

NO

MAYBE

 

 

PART IV - REASON FOR

FILING THIS REPORT

 

 

 

 

 

(Mark all that apply)

 

 

 

I am thin skinned

 

 

The Dept needs to fix my problems

 

Two beers is not enough

 

 

I am a wimp

 

 

My feelings are easily hurt

 

My hands should be in my pockets

 

I have woman / man-like hormones

 

I didn't sign up for this

 

I was not offered a tissue

 

 

I am a crybaby

 

 

I was told that I am not a hero

 

Someone requested a tissue

 

 

I want my mommy

 

 

The weather is too cold

 

All of the above and more

 

NARRATIVE (Tell us in your own sissy words how your feelings were hurt, as if anyone cared)

PART V - AUTHENTICATION

A. PRINTED REPORTER NAME (if you wish to be labeled too)

B. SIGNATURE (are you sure about this?)

C. PRINTED WHINER NAME (you really are going out on a limb here) D. SIGNATURE OF WHINER (you have got to be shitting me!)

We, as the Dept, take hurt feelings seriously. If you don't have someone who can give you a hug and make things all better, please let us know and we will promptly dispatch a "hugger" to you ASAP. In the event a "hugger cannot be found, an EMS Team will be dispatched to soak your socks in coal oil to prevent ants from crawling up your leg and eating their way up your candy ass. If you are in need of supplemental support, upon written request, we will make every reasonable effort to prvide you with a "blankie", a "binky" and/or a bottle if you so desire.

Document Information

Fact Name Details
Form Title Hurt Feelings Report
Submission Requirement The form must be physically handed to a Law Enforcement Officer.
Governing Law Privacy Act of 1974, 5 USC 301, and Departmental Regulation.
Purpose To assist individuals in documenting their hurt feelings.
Disclosure Policy Disclosure is voluntary; however, repeated submissions may lead to a derogatory label.
Sections Included The form contains five parts: Administrative Data, Incident Report, Injury, Reason for Filing, and Authentication.
Potential Support A "hugger" may be dispatched if needed, or EMS assistance can be provided.
Supplemental Support Upon request, items like a "blankie" or "binky" can be provided to those in need.

Hurt Feelings Report - Usage Guidelines

Once the Hurt Feelings Report form is completed, it should be handed directly to a Law Enforcement Officer. This ensures that your concerns are documented and addressed appropriately. Below are the steps to fill out the form accurately.

  1. Part I - Administrative Data:
    • Write your name in the format of Last, First, Middle Initial.
    • Indicate your age.
    • Specify your sex.
    • Enter the date when you are filling out the report.
    • Describe the type of whine you are using.
    • Provide the name of the person filling out the form, if different from you.
  2. Part II - Incident Report:
    • Record the date when your feelings were hurt.
    • Note the time when the hurtful comments were made.
    • Specify the location where the hurtful comments occurred.
    • Indicate if anyone was sympathetic to you, including any paid witnesses.
    • Write the name of the person who hurt your feelings.
    • State how long you have been whining about this incident.
    • List which specific feelings were hurt.
  3. Part III - Injury:
    • Circle which ear the hurtful words were spoken into: Left, Right, or Both.
    • Indicate if there is permanent feeling damage by selecting Yes, No, or Maybe.
    • State whether you required a tissue for tears.
    • Indicate if this incident resulted in a traumatic brain injury by selecting Yes, No, Multiple, or Maybe.
  4. Part IV - Reason for Filing This Report:
    • Mark all reasons that apply to your situation.
  5. Narrative:
    • In your own words, describe how your feelings were hurt.
  6. Part V - Authentication:
    • Print your name if you wish to be identified.
    • Sign the report to confirm your submission.
    • Print your name again if you are the whiner.
    • Sign again to authenticate the report.

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Dos and Don'ts

When filling out the Hurt Feelings Report form, there are certain guidelines to follow to ensure that your report is complete and taken seriously. Here are six things you should and shouldn't do:

  • Do provide accurate personal information, including your name, age, and the date of the incident.
  • Don't use offensive language or make jokes that could undermine the seriousness of your feelings.
  • Do clearly describe the incident that caused your hurt feelings, including the time and location.
  • Don't exaggerate your feelings or the situation; honesty is essential.
  • Do include any witnesses who may have been sympathetic to your situation.
  • Don't forget to sign the form; your signature is important for validation.

Following these guidelines can help ensure that your report is processed smoothly and respectfully. Remember, your feelings matter, and it is important to express them appropriately.

Common mistakes

  1. Incomplete Information: Failing to fill out all required fields can lead to delays in processing the report. Ensure that every section, such as the whiner's name and age, is fully completed.

  2. Not Providing Specific Details: Vague descriptions of the incident can hinder understanding. Include specific dates, times, and locations to give context to the feelings being reported.

  3. Ignoring the Narrative Section: Skipping the narrative part may result in a lack of clarity about the situation. This section is an opportunity to express how the incident affected you personally.

  4. Failure to Sign the Form: Not providing a signature can render the report invalid. Make sure to sign both as the reporter and as the whiner to authenticate the document.

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